DPA-Net: A Dual-Path Attention Neural Network for Inferring Glycemic Control Metrics from Self-Monitored Blood Glucose Data

Abstract

Continuous glucose monitoring (CGM) provides dense and dynamic glucose profiles that enable reliable estimation of Ambulatory Glucose Profile (AGP) metrics, such as Time in Range (TIR), Time Below Range (TBR), and Time Above Range (TAR). However, the high cost and limited accessibility of CGM restrict its widespread adoption, particularly in low- and middle-income regions. In contrast, self-monitoring of blood glucose (SMBG) is inexpensive and widely available but yields sparse and irregular data that are challenging to translate into clinically meaningful glycemic metrics. In this work, we propose a Dual-Path Attention Neural Network (DPA-Net) to estimate AGP metrics directly from SMBG data. DPA-Net integrates two complementary paths: (1) a spatial-channel attention path that reconstructs a CGM-like trajectory from sparse SMBG observations, and (2) a multi-scale ResNet path that directly predicts AGP metrics. An alignment mechanism between the two paths is introduced to reduce bias and mitigate overfitting. In addition, we develop an active point selector to identify realistic and informative SMBG sampling points that reflect patient behavioral patterns. Experimental results on a large, real-world dataset demonstrate that DPA-Net achieves robust accuracy with low errors while reducing systematic bias. To the best of our knowledge, this is the first supervised machine learning framework for estimating AGP metrics from SMBG data, offering a practical and clinically relevant decision-support tool in settings where CGM is not accessible.